TITLE Oro-pharyngeal HPV Study in Young Men Laura A Koutsky (PI) ABSTRACT Head and neck cancer (HNSCC) is the fifth most common malignancy worldwide. Human papillomavirus (HPV) infection has recently been identified as an etiologic agent for development of a subgroup of HNSCC (i.e., oro-pharyngeal cancers) with up to a third HPV-related and of those, 95% positive for HPV-16. Although HNSCC is rare in the United States, the incidence of HPV-related cases appears to have increased in the last 30 years, particularly in males. While much is known about the natural history and risk factors for cervical HPV infection, far less is known about the epidemiology of oro-pharyngeal HPV infection. The proposed oro- pharyngeal HPV study will investigate the incidence, natural history and determinants of oro-pharyngeal HPV infection in a healthy, young male population by adding oro-pharyngeal samples to our existing cohort study of genital HPV infections. We will use the same highly sensitive and specific PCR-based assays for oro- pharyngeal HPV testing, bi-weekly sexual history diaries, and 4-monthly examination schedules. Specifically we aim to (1) determine the prevalence, incidence and persistence of oro-pharyngeal HPV infection in young men, (2) evaluate the correlation between detection of HPV types in oro-pharyngeal samples versus genital and fingernail junction samples and (3) identify determinants of oro-pharyngeal HPV infection in men. The proposed study will provide some of the first data on the epidemiology and natural history of oro-pharyngeal HPV infections in young men. Such information is essential for understanding the etiology of HPV-related HNSCC and for developing preventative strategies based on early detection, behavioral modification, and HPV immunization. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Recently, human papillomavirus (HPV) infection was linked with cancers of the tongue, throat, and tonsils. Although these cancers are not common, they are often lethal, and their numbers are increasing in the male population of the US. The proposed cohort study of young men will provide new scientific knowledge that is essential for developing preventative strategies to reduce the global burden of HPV-related cancer of the tongue, throat, and tonsils.